Hospital drug shortages are just as important as primary shortages

I found your feature on medicines shortages interesting (
The Pharmaceutical Journal 2015;294:109). As a former medicines procurement specialist pharmacist and past chairman of the Pharmaceutical Market Support Group (PMSG), I have spent much of the latter part of my career working on managing medicines shortages in hospitals in England.

Although groups, such as the All-Party Pharmacy Group, have looked at medicines shortages, they have restricted themselves to shortages in primary care. It is true that shortages in primary care have the potential to affect significant numbers of patients, shortages of hospital injectable drugs have the potential for far more serious consequences, some of which are quoted in the feature.

My work in this area commenced with a project jointly funded by the NHS and Association of the British Pharmaceutical Industry (ABPI) in the south west of England where a system of managing serious shortages was developed across the region. The results of this were presented at a Procurement and Distribution Interest Group symposium.

Subsequently I was able to set up meetings between the ABPI, the British Generic Manufacturers Association and the British Association of Pharmaceutical Wholesalers with PMSG colleagues to look at ways of improving contracting and potentially reducing shortages.

Areas of discussion included extending lead times to contract commencement, improving medicines purchase data and, potentially, contracting for volumes as opposed to periods of time.

Following discussions with the Royal Pharmaceutical Society, Department of Health and other parties, guidance for chief pharmacists in English hospitals in managing medicines shortages was produced by the Society as part of its work on standards for hospital pharmacy services.

As a result of the work carried out by myself and other PMSG colleagues we estimated that in excess of £3m per year of pharmacy staff time was being wasted in chasing shortages, and this figure is now likely to be over £5m per year in England alone.

It was pleasing to see that, as a result of this and other work, the DH report on specialist pharmacy services published in 2014 clearly identified the need for a national shortages website.

I believe that this, together with legislation from the European Medicines Agency or the Medicines and Healthcare products Regulatory Agency, is the only way forward and I look forward to seeing a website, similar to the American Society of Health-System Pharmacists website, up and running before I enter my dotage.

This is too important a subject to be pushed into the background due to the lack of a suitable funding source.

David M. Stead

Bransgore,

Hampshire